Bacteriology of Naja atra Snakebite Wound and Its Implications for Antibiotic Therapy

摘要: Abstract A total of 112 cases Naja atra envenomation were examined at two referring hospitals: Taichung Veterans General Hospital in central Taiwan and Taipei (VGH-TP) northern Taiwan. Overall, 77% (86/112) developed clinically suspected wound infections 54% (61/112) required surgery secondary to tissue necrosis, finger or toe gangrene, and/or necrotizing fasciitis. Morganella morganii was the most abundant gram-negative bacterial strain isolated from bite wounds, followed by Proteus spp., Aeromonas hydrophila, Pseudomonas aeruginosa, Providencia spp. descending order; Enterococcus common gram-positive bacteria Bacteroides only anaerobic bacteria. A few episodes bacteremia caused Shewanella There no significant variations distribution species between these hospitals except for a higher incidence M. morganii, polymicrobial infection observed VGH-TP, which may have been related fecal flora prey oral individual snakes different geographic areas According susceptibility test involving various pathogens, first-line drug options management N. snakebite include monotherapy with ureidopenicillin combination therapy aminopenicillin third-generation cephalosporin fluoroquinolone. prospective evaluation empiric antibiotic should be considered.